將多餘卵子冷凍於下週期解凍受孕胚胎植入可達50-60%累積懷孕率

取卵後將多餘卵子冷凍，44-48h胚胎植入
若未懷孕，於下一週期解凍卵子ICSI受孕44-48h胚胎植入
<34歲可達63%累積懷孕率
35-40歲可達50%累積懷孕率
>40歲可達33%累積懷孕率

http://humrep.oxfordjournals.org/content/25/5/1199.full

Cumulative ongoing pregnancy rate achieved with oocyte vitrification and cleavage stage transfer without embryo selection in a standard infertility program

1. Filippo Ubaldi1, 
2. Reno Anniballo2, 
3. Stefania Romano1, 
4. Elena Baroni1,
5. Laura Albricci1, 
6. Silvia Colamaria1, 
7. Antonio Capalbo1, 
8. Fabio Sapienza1,
9. Gábor Vajta3 and 
10. Laura Rienzi1,*

+Author Affiliations

1. ¹G.EN.E.R.A Centre for Reproductive Medicine, Clinica Valle Giulia, Via G. De Notaris 2, 00197 Rome, Italy
2. ²Andrology Center ‘John McLeod’, via F. Petrarca, Naples, Italy
3. ³James Cook University, Cairns Campus, Cairns, QLD, Australia

1. *Correspondence address. E-mail: rienzi@generaroma.it

• Received December 9, 2009.
• Revision received January 13, 2010.
• Accepted January 20, 2010.

 

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Abstract

BACKGROUND Recent advancement of minimum volume vitrification methods has resulted in a dramatic increase in the efficiency of the process. The aim of this study was to estimate the cumulative reproductive outcome of a cohort of infertile couples undergoing ICSI and oocyte vitrification in restrictive legal conditions, where only a limited number of oocytes could be inseminated per cycle and embryo selection and cryopreservation were forbidden.

METHODS In this prospective longitudinal cohort study, the cumulative ongoing pregnancy rates obtained by the insemination of fresh and vitrified oocytes from the same cohort were calculated as primary outcome measures. Moreover, the effect of basal and cycle characteristics on clinical outcomes were assessed.

RESULTS Between September 2008 and May 2009, 182 ICSI cycles were performed where oocyte vitrification was possible. A total of 104 first and 11 second oocyte warming cycles were then performed in non-pregnant patients of the same cohort. The overall ongoing pregnancy rates obtained in the fresh, and first and second warming cycles were 37.4, 25.0 and 27.3%, respectively. The overall cumulative ongoing clinical pregnancy rate observed per stimulation cycle was 53.3%. Maternal age was the only characteristic found to influence the reproductive outcome, with an inverse correlation between the age >40 and the ongoing pregnancy rates (P = 0.04, by Cox regression analysis).

CONCLUSIONS High cumulative ongoing pregnancy rates can be obtained with transfers of embryos derived from fresh and cryopreserved oocytes in a typical infertile population. Female age significantly affects outcomes in this system.

Table III

Cumulative ongoing pregnancy rate after the fresh cycle, first warming cycle and second warming cycle according to female age.

	Overall	≤34 years	35–37 years	38–40 years	41–43 years
Fresh cycle	68/182 (37.4%)	29/72 (40.3%)	20/48 (41.7%)	15/41 (36.6%)	4/21 (19.0%)
(95% CI)	(31.2–45.1)	(29.7–51.9)	(28.8–55.8)	(23.6–52.0)	(7.8–40.3)
I warming cycle	94/182 (51.6%)	45/72 (62.5%)	23/48 (47.9%)	20/41 (48.8%)	6/21(28.6%)
(95% CI)	(44.4–58.8)	(50.9–72.8)	(34.4–61.7)	(34.2–63.6)	(13.9–50.2)
II warming cycle	97/182 (53.3%)	45/72 (62.5%)a	24/48 (50.0%)	21/41 (51.2%)	7/21 (33.3%)a
(95% CI)	(40.0–60.0)	(50.9–72.8)	(36.3–63.6)	(36.4–65.8)	(17.2–54.9)

• Data are expressed as absolute, percentage frequency and 95% CI.
• ^aP = 0.006.